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Some Studies on
ADHD & Thyroid


Home ||| Research Menu Page ||| Last update 01/02/2004

Listed in reverse date order:

Suresh 1999Subclinical hyperthyroidism and hyperkinetic behavior in children.
Erichsen 1998Thyroid hormone resistance. Clinical, biochemical and genetic study of a family
Hauser 1998Resistance to thyroid hormone: implications for neurodevelopmental research on the effects of thyroid hormone disruptors.
McDonald 1998Hyperactivity and learning deficits in transgenic mice bearing a human mutant thyroid hormone beta1 receptor gene.
Hauser 1997Thyroid hormones correlate with symptoms of hyperactivity but not inattention in attention deficit hyperactivity disorder.
Toren 1997Thyroid function in attention deficit and hyperactivity disorder.
Valentine 1997Thyroid function in a population of children with attention deficit hyperactivity disorder.
Weiss 1997Phenotype differences of resistance to thyroid hormone in two unrelated families with an identical mutation in the thyroid hormone receptor beta gene (R320C).
Weiss 1997Behavioral effects of liothyronine (L-T3) in children with attention deficit hyperactivity disorder in the presence and absence of resistance to thyroid hormone.
Kopp 1996Syndrome of resistance to thyroid hormone: insights into thyroid hormone action.
Matochik 1996Abnormalities in sustained attention and anterior cingulate metabolism in subjects with resistance to thyroid hormone.
Rovet 1996Thyroid hormone and attention in school-age children with congenital hypothyroidism.
Seto 1996Rapid molecular diagnosis of mutations associated with generalized thyroid hormone resistance by PCR-coupled automated direct sequencing of genomic DNA: detection of two novel mutations.
West 1996Differences in thyroid function studies in acutely manic adolescents with and without attention deficit hyperactivity disorder (ADHD).
Brucker Davis 1995   Genetic and clinical features of 42 kindreds with resistance to thyroid hormone. The National Institutes of Health Prospective Study.
Leonard 1995Magnetic resonance imaging of cerebral anomalies in subjects with resistance to thyroid hormone.
Hauser 1993Attention deficit-hyperactivity disorder in people with generalized resistance to thyroid hormone.
Weiss 1993Attention-deficit hyperactivity disorder and thyroid function.
Mixson 1992Correlations of language abnormalities with localization of mutations in the beta-thyroid hormone receptor in 13 kindreds with generalized resistance to thyroid hormone: identification of four new mutations.




  1. Genetic and clinical features of 42 kindreds with resistance to thyroid hormone. The National Institutes of Health Prospective Study. Brucker-Davis F et al, Ann Intern Med 1995 Oct 15;123(8):572-83
    "...104 patients with resistance to thyroid hormone from 42 kindreds and 114 unaffected relatives sharing the patients' environmental and genetic backgrounds. ... In persons with resistance to thyroid hormone, we measured the increased incidence of goiter (65%), attention-deficit hyperactivity disorder (60%), IQ less than 85 (38%), speech impediment (35%), and short stature (18%). We also described new clinical features, such as frequent ear, nose, and throat infections (56%); low weight-for-height in children (32%); hearing loss (21%); and cardiac abnormalities (18%). ..."
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  2. Thyroid hormone resistance. Clinical, biochemical and genetic study of a family, Erichsen KE, Berg JP, Torjesen PA, Haug E, Johannesen O, Tidsskr Nor Laegeforen 1998 Feb 10;118(4):525-9
    "We here present a family where three individuals in three generations had varying degrees of goiter, tachycardia, fatigue, hyperactivity, and learning disability. Serum T3 and free T4 were elevated, whereas TSH was normal or slightly increased. The clinical findings in combination with the hormone values led to several supplementary investigations and therapies being carried out, but they had no beneficial influence on the patients' symptoms. ... This mutation has previously been shown to decrease receptor affinity for T3..."
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  3. Attention deficit-hyperactivity disorder in people with generalized resistance to thyroid hormone., Hauser P, et al, New England Journal of Medicine 1993 Apr 8;328(14):997-1001
    "...We systematically evaluated the presence and severity of attention deficit-hyperactivity disorder in 18 families with a history of generalized resistance to thyroid hormone. ... In our study sample, attention deficit-hyperactivity disorder is strongly associated with generalized resistance to thyroid hormone. "
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  4. Resistance to thyroid hormone: implications for neurodevelopmental research on the effects of thyroid hormone disruptors., Hauser P, McMillin JM, Bhatara VS, Toxicol Ind Health 1998 Jan-Apr;14(1-2):85-101
    ". . .There is increasing evidence that exposure to certain synthetic compounds, including dioxins and polychlorinated biphenyls (PCBs), during the perinatal period can also impair learning, memory, and attentional processes in offspring. Animal and human studies suggest that exposure to these environmental toxicants impair normal thyroid function. Although the precise mechanisms of action of the adverse effects these toxicants have on neurodevelopment have not yet been elucidated, it is possible that they are partially or predominantly mediated by alterations in hormone binding to the thyroid hormone receptor. . .
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  5. Thyroid hormones correlate with symptoms of hyperactivity but not inattention in attention deficit hyperactivity disorder., Hauser P, Soler R, Brucker-Davis F, Weintraub BD, Psychoneuroendocrinology 1997 Feb;22(2):107-14
    "... In this study, the relationship between thyroid hormones and symptoms of hyperactivity was examined in subjects with resistance to thyroid hormone (RTH) and their unaffected family members. ... in the RTH [resistance to thyroid hormone] group, both TT3 and TT4 concentrations were significantly and positively correlated with total symptoms of ADHD ... as well as symptoms of inattention ... and symptoms of hyperactivity ... The data support the hypothesis that thyroid hormones may provide a physiological basis for the dichotomy between symptoms of inattention and symptoms of hyperactivity..."
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  6. Syndrome of resistance to thyroid hormone: insights into thyroid hormone action., Kopp P, Kitajima K, Jameson JL, Proc Soc Exp Biol Med 1996 Jan;211(1):49-61
    "... Resistance to thyroid hormone (RTH) is a rare disorder caused by mutations in the TR beta gene. Biochemically, the syndrome is defined by elevated circulating levels of free thyroid hormones due to reduced target tissue responsiveness and normal, or elevated, levels of thyroid-stimulating hormone (TSH). ... pituitary resistance results in hypersecretion of TSH, which compensates, at least in part, for hormone resistance in peripheral tissues. Despite this compensation, clinical effects of RTH can include short stature, delayed bone maturation, hyperactivity, learning disabilities, and hearing defects, ...".
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  7. Magnetic resonance imaging of cerebral anomalies in subjects with resistance to thyroid hormone. Leonard CM, Martinez P, Weintraub BD, Hauser P, Am J Med Genet 1995 Jun 19;60(3):238-43
    "... Individuals with RTH [resistance to thyroid hormone] have an increased incidence of attention deficit hyperactivity disorder (ADHD). The purpose of this study was to search for developmental brain malformations associated with RTH. ...Abnormal thyroid hormone action in the male fetus early during brain development may be associated with grossly observable cerebral anomalies of the left hemisphere..."
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  8. Abnormalities in sustained attention and anterior cingulate metabolism in subjects with resistance to thyroid hormone. Matochik JA, Zametkin AJ, Cohen RM, Hauser P, Weintraub BD, Brain Res 1996 Jun 3;723(1-2):23-8
    "Attention deficit disorders are a frequent manifestation of resistance to thyroid hormone (RTH), a disorder caused by mutations in the hormone-binding domain of the human thyroid hormone receptor beta gene. Positron emission tomography was used to measure cerebral glucose metabolism in regions known to be biological determinants of sustained attention ... Compared to the control group, performance ... was severely impaired in the RTH subjects, while metabolism was higher both in the right parietal cortex and the anterior cingulate gyrus. ..."
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  9. Hyperactivity and learning deficits in transgenic mice bearing a human mutant thyroid hormone beta1 receptor gene. McDonald MP, Wong R, Goldstein G, Weintraub B, Cheng SY, Crawley JN, Learn Mem 1998 Sep-Oct;5(4-5):289-301
    "... The syndrome is characterized by reduced tissue responsiveness to thyroid hormone and elevated serum levels of thyroid hormones. A common behavioral phenotype associated with RTH [Resistance to Thyroid Hormone] is attention deficit hyperactivity disorder (ADHD). . . . Male transgenic mice showed elevated locomotor activity in an open field compared to male wild-type littermate controls. Both male and female transgenic mice exhibited impaired learning of an autoshaping task, compared to wild-type controls. . . . These results indicate that transgenic mice bearing a mutant human TRbeta gene demonstrate several behavioral characteristics of ADHD . . ."
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  10. Correlations of language abnormalities with localization of mutations in the beta-thyroid hormone receptor in 13 kindreds with generalized resistance to thyroid hormone: identification of four new mutations. Mixson AJ, Parrilla R, Ransom SC, Wiggs EA, McClaskey JH, Hauser P, Weintraub BD, J Clin Endocrinol Metab 1992 Oct;75(4):1039-45
    "...Kindreds with mutations in exon 9 compared with those in exon 10 have significantly more problems in language development, as manifested by articulation problems and/or wide discrepancies in verbal and performance IQs. ..."
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  11. Thyroid hormone and attention in school-age children with congenital hypothyroidism. Rovet J, Alvarez M, J Child Psychol Psychiatry 1996 Jul;37(5):579-85
    " The relationship between attention and thyroid hormone was examined using a retrospective database of 85 7-year-old children with congenital hypothyroidism who received psychological evaluations and thyroid function tests on the same day. . . Children with high levels of both hormones were found to be significantly more distractable on an index of cognitive attention but were reportedly less hyperactive. Level of thyroxine accounted for over 10% of the variance in attention."
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  12. Rapid molecular diagnosis of mutations associated with generalized thyroid hormone resistance by PCR-coupled automated direct sequencing of genomic DNA: detection of two novel mutations. Seto D, Weintraub BD, Hum Mutat 1996;8(3):247-57
    " Generalized thyroid hormone resistance (GTHR) is a syndrome characterized by tissue nonresponsiveness to thyroid hormones and by variable clinical phenotype manifestations. This syndrome has also been implicated as a predisposing factor in some cases of attention deficit-hyperactivity disorder (ADHD). GTHR results from single mutations in the gene encoding the thyroid hormone receptor. . . . The rapid molecular diagnostic protocol, from whole blood to DNA sequence data, takes approximately 15 hr, allowing for rapid, efficient, and unambiguous direct detection of the mutant alleles."
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  13. Subclinical hyperthyroidism and hyperkinetic behavior in children. Suresh PA, Sebastian S, George A, Radhakrishnan K, Pediatr Neurol 1999 Mar;20(3):192-4
    " The authors report three children who exhibited developmental learning disabilities (DLDs) associated with behavioral disturbances, such as attention deficit, hyperactivity, and autistic features. The thyroid function tests performed as a part of routine endocrinologic evaluation of children with DLDs revealed a hormonal profile consistent with hyperthyroidism. These children had no systemic signs of hyperthyroidism. Treatment with neomercazole resulted in good control of their hyperkinetic behavior and subsequent improvement in language function attributable to an increased attention span, thereby facilitating speech therapy. . . ."
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  14. Thyroid function in attention deficit and hyperactivity disorder. Toren P et al., J Psychiatr Res 1997 May-Jun;31(3):359-63
    " . . . we performed a replication study to clarify the issue and establish clinical guidelines. Thyroid tests were performed in 43 ADHD children and 28 age- and gender-matched controls. Sixteen ADHD children showed total triiodothyronine (TT3) levels which were slightly above the upper limit of normal, but no significant difference in TT3 values was noted between the ADHD and the control groups. Moreover, none of the ADHD subjects had abnormal levels of total thyroxine, free thyroxine, thyroid stimulating hormone or total triiodothyronine reuptake. The present study supplies additional evidence for the lack of an association between thyroid function and ADHD, and counters the suggestion that thyroid function be routinely screened for in ADHD children."

    NOTE:  Consider whether you agree with the author's conclusion. More than 37% of the children were slightly above the upper limit of normal. If, in 43 children, a relatively rare serious thyroid problem is not found, is that really grounds not even to look for such a problem? If the problem cannot be fixed, perhaps it does not pay to know about it. However, since thyroid dysfunction can be treated, what is the sense of not checking to rule it out? No one is suggesting that thyroid dysfunction is the only cause of ADHD.

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  15. Thyroid function in a population of children with attention deficit hyperactivity disorder. Valentine J, Rossi E, O'Leary P, Parry TS, Kurinczuk JJ, Sly P, J Paediatr Child Health 1997 Apr;33(2):117-20
    " . . .The prevalence of thyroid hormone abnormalities in the study population was 2.3% . . . There were no cases of generalized resistance to thyroid hormone. The prevalence of thyroid hormone abnormalities in the general population of children and adolescents has been reported to vary between 1 and 3.7%. CONCLUSION: Routine thyroid hormone screening is not indicated in children with non-familial ADHD."

    NOTE:  In the opinion of a parent who is not a medical professional -- Considering the expense and heartbreak of treating a child with ADHD for many years when there is even a 2% chance of finding a correctable problem, it seems illogical not to screen for it. A thyroid test is neither invasive nor dangerous.

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  16. Attention-deficit hyperactivity disorder and thyroid function. Weiss RE, Stein MA, Trommer B, Refetoff S, J Pediatr 1993 Oct;123(4):539-45
    " . . . We report a prospective screening study for thyroid abnormalities in 277 children with ADHD by measurement of serum levels of total thyroxine, free thyroxine index, and thyrotropin. Fourteen children with ADHD had thyroid function test abnormalities: six had a normal free thyroxine index and elevated thyroxine level (group 1); three had a high free thyroxine index and a normal thyrotropin level (group 2); and five had a low free thyroxine index with a normal thyrotropin level (group 3). . . . Although the prevalence of ADHD in subjects with GRTH [general resistance to thyroid hormone] has been reported to be 46%, the overall prevalence of GRTH must be less than 1:2500 because we failed to detect GRTH in the 277 children with ADHD studied. We conclude that the prevalence of thyroid abnormalities is higher (5.4%) in children with ADHD than in the normal population (< 1%)."
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  17. Phenotype differences of resistance to thyroid hormone in two unrelated families with an identical mutation in the thyroid hormone receptor beta gene (R320C). Weiss RE, Tunca H, Knapple WL, Faas FH, Refetoff S, Thyroid 1997 Feb;7(1):35-8
    "... In one of the two families higher concentrations of free T4 were required to maintain a normal TSH level in affected subjects......it is uncertain whether the higher thyroid hormone levels prevented the occurrence of hyperactivity and attention deficit."
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  18. Behavioral effects of liothyronine (L-T3) in children with attention deficit hyperactivity disorder in the presence and absence of resistance to thyroid hormone. Weiss RE, Stein MA, Refetoff S, Thyroid 1997 Jun;7(3):389-93
    " Evidence that the thyroid may play a role in the pathogenesis of attention deficit hyperactivity disorder (ADHD) comes from observations that 48% to 73% of children with the syndrome of resistance to thyroid hormone (RTH) have ADHD. . . . A prospective, randomized, double-blinded, placebo-controlled, cross-over study was conducted . . . In children with RTH and ADHD, particularly those that exhibit hyperactivity, L-T3 in supraphysiological doses may be beneficial in reducing hyperactivity and impulsivity. In the majority of children with ADHD who do not have RTH, L-T3 treatment has no effect or may be detrimental."
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  19. Differences in thyroid function studies in acutely manic adolescents with and without attention deficit hyperactivity disorder (ADHD). West SA, Sax KW, Stanton SP, Keck PE Jr, McElroy SL, Strakowski SM, Psychopharmacol Bull 1996;32(1):63-6
    " The purpose of this study was to compare basal thyroid indices in adolescent (ages 12 to 18) bipolar patients with and without attention deficit hyperactivity disorder (ADHD). . . . Twenty patients (66%) had comorbid ADHD. The mean serum T4 concentration in this group was significantly lower than it was for patients with bipolar disorder alone. There were no significant differences between groups in serum T3 or TSH concentrations. . . this may have important implications regarding the potential benefits of thyroid supplementation in adolescents with bipolar disorder and comorbid ADHD who do not respond to mood stabilizers alone."
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